I want the best service: How to save hundreds of lives by fixing emergency service

I wrote this with Daniel Hunter during my campaign for City Council in 2007.

If you are shot——or have a heart attack—where would you rather be, New York City or Philadelphia?  If you want to stay alive, the unfortunate answer is New York City.

Why? New York City has invested resources in emergency medical services. And they don’t hamstringing their paramedics, fire fighters, and police with unreasonable rules.

Here’s one example: New York City has far more ambulances per person than Philadelphia. They have so many ambulances, in fact, that they don’t have enough stations for all of them. That’s why you see many parked on street corners waiting for a call.

In Philadelphia the situation is the opposite.  We have too few ambulances.  So when police rush onto the scene after someone is shot, they often arrive long before an ambulance.  As a result, they have to put gunshot victims in their police cruisers to drive them to ambulance. And most police officers are not trained to provide emergency medical care.

And even when an ambulance arrives, sometimes it is staffed not by paramedics but by emergency medical technicians (EMTs) who don’t have the training and are not licensed to do many procedures that paramedics can do. EMTs can’t break the skin. So they can’t give shots or start intravenous lines or use advanced techniques to support breathing.

Basic EMTs are usually restricted to using oxygen, glucose, asthma inhalers, and epinephrine auto-injectors (a common exception to the no-needles rule). Paramedics are trained in the use of 30-40 medications, depending on the state.

It’s a shame, because Philadelphia has some of the bravest paramedics, firefighters, and police officers. Yet they don’t have the resources to save the lives of all the Philadelphians who need them. Our paramedics have some of the highest call volume of any in the city. They are overworked and overstressed. And they simply can’t get to those who need them fast enough.

I want the best emergency medical services for everyone in this city.

I’m just now starting to enter the age when there is a possibility I could have a heart attack or stroke. The Street Administration is risking not only the lives of gunshot victims but those of us who might need emergency medical services.

For months the administration has refused to sign a binding contract award with the City’s firefighters and paramedics. The paramedics are asking for some sensible policies, such as allowing the many firefighters who have been cross-trained as paramedics to provide emergency medical services.

Such a policy increases the chances of someone surviving a heart attack by leaps and bounds.  Without such a policy, the chances for surviving a cardiac arrest may be as low as 4% under the Street Administration.

Even trained paramedics are sometimes hamstrung by laws which refuse to allow them to use certain equipment because of their role.  So even though they have the training, they are not allowed to perform their skill.  They’re not allowed to save lives!

Moving towards the best service means that we need to release people to use the skills they have.  With a swish of the pen the Street Administration could have potentially saved dozens of lives. But politics has stood in the way of common sense.

It’s time for a new politics of hope that fixes our broken politics.

It’s time we aim for the best service and don’t take no as answer.

Because it’s not just about politics: Our lives are at stake.